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Molecular detection of Plasmodium in areas of autochthonous malaria in the Atlantic Forest biome of the State of São Paulo - the role of asymptomatic infections in the maintenance of transmission

Grant number: 18/07890-5
Support type:Scholarships in Brazil - Master
Effective date (Start): October 01, 2018
Effective date (End): April 30, 2020
Field of knowledge:Health Sciences - Collective Health
Cooperation agreement: Coordination of Improvement of Higher Education Personnel (CAPES)
Principal Investigator:Silvia Maria Fátima Di Santi
Grantee:Maria de Lourdes Rego Neves Farinas
Home Institution: Superintendência de Controle de Endemias (SUCEN). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Malaria is an infectious disease that challenges the science and the control programs. In Brazil, most cases occur in the Amazon region, with 193,886 news cases in 2017, a worrying increase of 51% compared to 2016. In the Extra-Amazon Region, the impact of the disease is due to imported cases and to the occurrence of outbreaks. In 2017, from 445 reported cases, 86 were classified as autochthonous, with low parasitemia and poor symptomatology. The State of Sao Paulo notified 14 autochthonous cases in 2017, all in regions located in the Atlantic Forest. This number may be higher, since the cases were diagnosed by the malaria reference test, the thick blood smear, whose sensitivity varies depending on the observer's experience and blood parasitemia. Due to their high sensitivity, molecular tests have been used for detection of asymptomatic infections with low parasitemias. The objective of this study is to apply PCR protocols (qPCR, LAMP and nested PCR) in 537 blood samples from individuals living in outbreak areas, in municipalities of the State of Sao Paulo covered by Atlantic Forest. The use of molecular protocols in the population from areas near to the index cases will allow the detection of asymptomatic individuals harboring Plasmodium that acts as source for the transmission of new cases. Additionally, will provide the accurate diagnosis of the circulating Plasmodium species. The results will be useful for evaluating the profile of the outbreaks areas, improving the control strategies in autochthonous events.Keywords: Malaria, molecular diagnosis, asymptomatic cases.